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Defining Preeclampsia
Preeclampsia is a condition that occurs among pregnant women who are usually in their second trimester . However, preeclampsia can occur very early or even during the third trimester. This is significantly marked by elevated blood pressure and increase protein in the urine. Indications that a pregnant woman might be suffering from preeclampsia is swelling or edema. It is usually evident on the hands and face of the pregnant woman.
It differs from eclampsia in a sense that preeclampsia is less severe, and eclampsia is usually accompanied by seizures or convulsions . A woman who is also suffering from eclampsia may fall into a coma, which could have negative implications to both the mother and the fetus.
Pathophysiology of the Disease
There are no identifiable predisposing factors that have been identified to cause preeclampsia. Although many believe that it develops because of the improper development of the placenta, other factors that are suspected to have cause preeclampsia are compromised blood flow to the uterus, high body fat and poor nutrition.
At high risk of developing Preeclampsia
Women who are in their 40’s are prone to develop preeclampsia. In addition, anyone who has a history of high blood pressure, preeclampsia or a family history of preeclampsia is at risk of having the condition. In addition, women who are obese, with a history of kidney problem, diabetes, lupus and arthritis are also at high risk. There were also incidents where women who are carrying multiple fetuses are at higher risk.
Signs and Symptoms
While it is normal to gain weight during the period of one's pregnancy, rapid gain weight should be an indicative sign of preeclampsia. This weight gain is usually caused by water retention, which causes edema. If the woman noticed that amidst high fluid intake, urination has been less frequent or if there is excessive vomiting and nausea then it might be a sign that a woman are suffering from preeclampsia.
Things to be on the lookout for
While swelling is usually normal for pregnant women, these are usually confounded within the feet and the angle. However, when faces, hands and eyes began to swell, the mother should be taken into her physician. Since high blood pressure is listed as one of the conditions associated with preeclampsia, blood pressure of 140/90 should be something alarming. Severe headaches, abdominal pains, are also to look out for. Decrease in urine output is also something to be worried.
History and Physical Examinations
Patient’s Name : Rhia Santos
Sex : Female
Age : 41 yrs old
Weight : 89 kg.
Allergies : Penicillin
Physician : Dr. Samantha Griffin, M.D.
Admission Date : June 16, 2014
Admission Diagnosis : High blood Pressure 150/120
Edema (+) feet, face, hands
History : Patient Rhia Santos, age 41 y/o. entered the E.R. at 2:45am, ambulatory with supportive presentation of the abdomen projecting signs of physical discomfort, i.e. excruciating pain. Patient verbally complains of severe abdominal pain followed by excessive vomiting. Patient also noticed a significant decrease in the frequency and quantity of her urine. Patient reported to have a blood pressure of 130/90 prior to pregnancy and was advised to take medication for her high blood pressure. Patient is in her 18 wk 4 days gestational age.
Review of Systems
Plan of Care
- Monitor of I/O to document fluids level to prevent dehydration
- Monitor BP every 6 hours
- Eat proper diet, especially one that includes no fat, no salt diet
- Document weight gain
- Be on the lookout for red flags which would mean automatic medical attention:
- Rapid weight increases if weight increases everyday or every 2 days.
- Edema on face, hands and eyes
- Signs of dehydration
- High BP (>/=140/90)
- Severe headache, abdominal pain
- Bleeding
Reference
Achley, B., & Ladwig, G. (2010). Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care, 9e. Maryland Heights, Missouri: Mosby.
Ward, S., & Hisley, S. (2011). Maternal-Child Nursing Care with the Women's Health Companion: Optimizing Outcomes for Mothers, Children and Families, Revised Edition. Philadelphia, Pennsylvania: F.A. Davis Company.
